ERs Report Calm During Storm, Mangled Hands After

by John Gever John Gever,Senior Editor, MedPage Today
February 02, 2011

Emergency departments in areas blasted by this winter's record snowfalls say the storms themselves have offered something of a respite from what has otherwise been a steady stream of heart attacks and injuries related to the freakish weather.

In Chicago, which is now digging out from its third biggest snowstorm ever, hospital staff told MedPage Today and ABC News that their emergency rooms are relatively quiet, although they expect to see more patients once people and cars venture out again.

A spokeswoman for Northwestern Memorial Hospital in Chicago said in an e-mail early Wednesday that the emergency department "has only a handful of patients. This is not surprising to emergency room doctors due to the fact that it's difficult to travel and people aren't really walking in from the street."

She said the hospital had a busy period during the night when "30 to 40 stranded motorists" who had been rescued from a huge traffic jam on Lake Shore Drive were brought in for warming, with some needing minor medical care as well.

Added a spokesman for the University of Chicago Hospital, "[Our ED is] as empty as I have ever seen it."

Because hospitals in the Midwest had two days of warnings before the snow hit, they had plenty of time to prepare.

At Henry Ford Hospital in Detroit, a spokesman said in an e-mail that seven patients with elective surgeries scheduled for Wednesday were brought in Tuesday "so they didn't have to travel in the snow." He said many surgeries had been rescheduled for later in the week.

"Hundreds of staff ... spent the night at the hospital to ensure they would be on time for their morning shifts," he added.

Along the East Coast, which has been struck repeatedly with heavy snows starting the day after Christmas, emergency personnel reported that they had seen waves of patients with weather-related problems immediately after each storm subsided.

Alan Jon Smally, MD, medical director of the emergency department at Hartford Hospital in Connecticut -- where more snow and ice were expected Wednesday -- told MedPage Today and ABC News in an e-mail that he anticipated "a lot of snowblower (severe) hand injuries, heart attacks (shoveling), and car crashes today and tomorrow."

In New Jersey, where the snow totals through January were already about double the historical average for an entire winter, weather-related emergency department visits also appear to be running ahead of normal.

A spokeswoman for St. Barnabas Medical Center in Livingston, N.J., said the hospital was seeing about two heart attacks related to snow shoveling with every storm, an increase over the norm.

"Our cardiologists are concerned that the public does not understand (1) how strenuous shoveling really is and (2) the role of the cold in relation to vasoconstriction, which ultimately stresses the body even more," she wrote in an e-mail.

The mix of weather changes the types of injuries requiring emergency treatment, the Northwestern Memorial Hospital official pointed out.

"This year the emergency room is seeing a lot of fractures due to the temperature fluctuations," she said. "The warm weather caused a lot of snow to melt and then a quick freeze created sheets of ice. They are seeing ... worse fractures this year compared to over the past few years."

The weather also affects patients in other ways. The director of emergency medicine at the University of Iowa in Iowa City noted that bad weather can prevent transfers between hospitals.

"I have been providing phone consultation with smaller ERs on how to care for severely injured/ill who can't be transferred to us because of the weather," wrote Michael P. Miller, MD, in an e-mail.

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